Lyme disease is a bacterial infection caused by Borrelia burgdorferi, which
is transmitted by the tick Ixodes. The tick picks up the
bacteria when it bites mice or deer that are infected with the bacterium. The
bacteria can be transmitted to anyone bitten by an infected tick.
Lyme disease was first reported in the United
States in 1977 in the town of Old Lyme, Connecticut. Lyme disease has a
worldwide distribution, but it is seen most commonly in the US.
There are 3 stages of Lyme disease:
• Stage 1 is called early-localized Lyme disease.
The infection has not yet spread throughout the body.
•
Stage 2 is called early-disseminated Lyme
disease. The bacteria have begun to spread throughout the body.
•
Stage 3 is called late-disseminated Lyme
disease. The bacteria have spread throughout the body.
Risk factors for Lyme disease include:
• Outside activities that increase tick exposure
(for example, gardening, hiking, or hunting) in an area where Lyme disease is
known to occur.
• Having a pet that may carry ticks home.
Important facts:
•
A tick must be attached to your body for about a
day or more to spread the bacteria to your blood.
•
Many people with Lyme disease never knew they
were even bit by a tick.
•
Most people who are bitten by a tick do not get
Lyme disease.
Symptoms
Early localized Lyme disease (stage 1) begins
days or weeks after infection and includes flu-like symptoms such as, fever,
chills, headache, malaise, joint pain, muscle pain and stiff neck.
The characteristic skin presentation is a "bull's
eye" rash, which is a flat or slightly raised red rash at the site of the
tick bite. The red rash has central clearing and can
expand in size. This rash is called erythema migrans. Erythema migrans is seen
in 60– 90% of patients diagnosed with the disease. Without treatment, it can
last 4 weeks or more.
If Lyme disease is untreated it can spread to
the brain, heart, and joints, this is Early-disseminated Lyme disease (stage 2).
This may occur weeks to months after the tick bite, and may include:
•
Numbness or pain in the area, paralysis or
weakness in the muscles of the face, heart problems, chest pain, or shortness
of breath.
Late disseminated Lyme disease (stage 3) can
occur months or years after the infection. The most common symptoms are muscle
and joint pain.
Exams and Tests
A blood test can be done to check for antibodies
to the bacteria that cause Lyme disease. The most commonly used is the ELISA
for Lyme disease.
Treatment
A 10 day to 4-week course of doxycycline
antibiotics is used to treat Lyme disease in adults and Amoxicillin is generally
used in children less than 8 years of age or in pregnant women.
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